In 1997, Book-It Repertory Theatre of Seattle, created a narrative-style theatrical adaptation of the novel's fourth chapter, "The Little Lord Jesus." The adaptation is titled "Owen Meany's Christmas Pageant" and has been produced seven times.
The 1998 feature-length film Simon Birch, directed by Mark Steven Johnson, was loosely based on the novel. The film starred Ian Michael Smith, Joseph Mazzello, Ashley Judd, Oliver Platt and Jim Carrey. It omitted much of the latter half of the novel and altered the ending. The movie does not share the same title as the book or the character names at Irving's request; he felt that it would "mislead the novel's readers to see a film of that same title which was so different from the book."
In 2002, the Royal National Theatre staged Simon Bent's adaptation A Prayer for Owen Meany: On Faith starring Aiden Mcardle as the title character.
In 2009, the BBC aired Linda Marshall Griffiths' adaptation of A Prayer for Owen Meany starring Henry Goodman, Toby Jones, Charlotte Emmerson and Max Baldry as a five-part Afternoon Play on BBC Radio Four.
In 2009, Audible.com produced an audio version of A Prayer for Owen Meany, narrated by Joe Barrett, as part of its Modern Vanguard line of audiobooks.
There have also been numerous theatrical adaptations, including Yale University's Dramatic Association's Freshman Show.